Blood ComponentsIndependent Double Checks

Chris Downey RN CPN(C) MSc RNFA

Blood Components Independent Double Checks

What are classed as blood components?Autologous whole blood (lifespan of 35

days)Red blood cells (RBCs or packed cells)Frozen plasma (FFPs)Cryoprecipitate (Factor VIII)Platelets

Blood Components Independent Double Checks

Blood products are never stored in a regular fridge Brought into the room in a cooler with cool paks

Bacterial proliferation &/or loss of function in blood

components

2 blood fridges in the OR, one in Connell anesthesia room and one in Kidd coreWhere there is a definite need, Type and CrossWhere there is a potential need, Type and Hold

(KGH Blood Schedule)

Blood Components Independent Double Checks

Why Independent Double Checks? Literature on blood administration states:

Errors of commission 1 in 1000 Errors of ommission 1 in 100 Errors in high stress environments with rapidly occuring

events 1 in 4 Serious Hazards of Transfusion reports (SHOT) demonstrate

cases of incorrect transfusion often result from a sequence of errors involving failure to detect the incorrect identity of the patient &/or the blood component.

Blood Components Independent Double Checks

Policies controlling Blood Administration (Adult & Peds, not Neonates) Intranet > KGH Community > Admin

Policy Manual 06-040 Consent for Blood Administration 13-010 Patient Identification 20-020 Administration of Blood Products 20-025 Administration of Plasma Derivatives

Blood Components Independent Double Checks

According to Policy Prior to infusing RBC’s 2 practitioners (RN, RT, Docs,

Perfusionists) will perform independent double checks- Exception: In an emergency situation where the

practitioner is of the opinion that the time to do a double check would put the patient at risk of serious harm.

Blood Components Independent Double Checks

Documentation All blood products have a removable label that may

be attached to the “Blood Components/Products Transfusion Record” (pink sheet-SAP # 278 )

In the OR, when blood has been checked, Nurses will put initials on the removal label

Do not put initials on the bag or the CBS label (bag cannot be reused by blood services)

Blood Components Independent Double Checks

B79269

Blood Components Independent Double Checks

Blood band #Patient Name

Blood Unit # Compatibility

Blood Components Independent Double Checks

Blood band #Patient Name

B79269

Blood Components Independent Double Checks

B79269

B79269

Blood Unit #Blood band #

Compatibility

ABO Rh

Blood Components Independent Double Checks

If any part of the check is not correct:

DO NOT TRANSFUSE

Determine if the case should proceed if the appropriate amount of blood is not available;

Identify to team members that there is a discrepancy, repeat the check; and

If discrepancy still exists give unit(s) to the Perioperative RN and call Blood Bank (4188) stating the discrepancy.

(…You may want to ask Blood Bank if they require more serum or are they able to retype and cross with what they have)